A Successful Organized Effort to Improve Operating Room First-Case Starts in a Tertiary Academic Medical Center.

Background: Operating room (OR) inefficiency drives up cost, decreases revenue, and leads to surgeon, staff, and patient dissatisfaction. Given a low mean first-case start rate in our tertiary academic medical center, we developed a process to improve first-case start rates in an effort to increase OR efficiency.

Methods: A working group of the OR Executive Committee was constituted to develop and implement a multistep operational plan.